Having coffee with a friend who’s a doctor can lead to some pretty interesting conversation. You learn a lot about a lot of things you don’t necessarily want to learn – and the answers to questions you never thought needed asking.
Sometimes.. it’s just fun to pick the doctor’s brain with “what would you do” scenarios. Yesterday’s coffee house conversation was quite the learning experience and let’s hope you never have to do this, but just in case…
Let’s say you owe a rather large sum of to Vinnie, the leader of a local mob who has made monthly protection payments a requirement (kind of like Obamacare). Vinnie barges into your restaurant with his goons and they demand that you pay up. You’ve never been one much for threats so you resist. Vinnie is a creative crime-lord though and instead of shooting you with two in the chest, he turns to one of your regular patrons and orders his goons to hold him down – at which point Vinnie whips out a large axe and in one swipe.. he chops the man’s arm off.
Vinnie says he’ll be back again next month and expects payment in full. You now understand that Vinnie takes his business proceedings pretty seriously – and you probably should to.
But for now.. you’ve got a guy with a missing arm on the floor of your restaurant and that’s just bad for business. Thankfully, he was eating with some friends and they are quick to scoop him up off the floor and rush him out the door and into the car – en route to the hospital no doubt.
But dammit.. they left his arm laying there. He’s probably going to want that. Maybe they didn’t think it could be reattached but with the proper care and treatment, there’s a good chance someone can sew that appendage back on.
How to Save Life and Limb
1. Stop the Main Arteries From Bleeding – Pick that bloody stump of an arm off the floor and look for the arteries. They’ll be easy to identify because they’ll be expanding and contracting while shooting blood all over the place.
In the present scenario, you’ll be looking to apply a tourniquet to the brachial artery. That’s the main artery running through the arm. If Vinnie had chopped off this man’s leg, you would want to identify the femoral artery.
Grab your tourniquet material. If someone near has a tie on, ask him for it. Take your shirt off and use it if you have to.
2. How to Apply the Tourniquet – If you can get help from someone nearby, have the person pinch the artery while you tie your make-shift tourniquet around the entire arm – just as close to the end as you can get it. This should be a fairly tight cinch but no so tight as to crush tissue. Just focus on making it tight enough to allow the blood to clot and stop the bleeding.
3. Cinch off the Blood Vessels – Now that you’ve got the tourniquet applied, it’s time to take care of the blood vessels. It could get tricky here because you need some type of string, fishing line or even dental floss to tie the arteries off. If you have none, it’s going to be a long ride to the hospital while holding the blood in those arteries.
If you find something to tie the vessels off with, push the blood up in the vessel as high as you can and wrap the material around the blood vessel many times. Tie it off as high as you can. Just think of it as a balloon filled with water and you’re squeezing the water up to tie off the balloon.
4. Clean the Arm Immediately – If there’s foreign material, remove it. If you see crushed parts hanging down, feel free to take a pair of scissors and trim them off. They can’t be restored. At this point, wash the wound and do so vigorously – with a stream of water directly on it.
Treat this as an art project and make it look nice.
5. Remove the Tourniquet – After the tourniquet pressure is decreased, you can remove the tourniquet. Be sure that the bleeding is nothing more than an ooze – the mark of a successful tourniquet application.
You don’t want to leave a tourniquet on any longer than 90 minutes or you’ll risk losing live tissue where the tourniquet has been applied.
6. Coat and Ice – Before rushing the arm off to the hospital, look for an anti-biotic Ointment that will help reduce infection (mupirocin works great). Cover the bloody stump with a clean cloth – this not only helps it but will save many toddlers from having recurring nightmares when you arrive at the hospital with your package.
Throw some ice on the end of the arm and head to the hospital. You’ve got an average of six hours to work with in which the limb can be reattached and still work – though this guy is not likely to win any future CrossFit competitions.
Armed With New Knowledge!
You’ve done it! As you enter the hospital, feel free to strut with a bit of bravado as you ready yourself to handover your perfectly sutured arm. You might want to make sure and provide a clear explanation of what you’re dropping off before actually turning the goods over to the emergency room receptionist. She sees a lot on her job but she’s probably still not ready for this.
As you head back to the restaurant, you contemplate all the cleaning that you’ll soon be doing. It’s going to be a lot of scrubbing and hard work and that’s just discouraging. You’ve got chicken to fry and soup to make. And Vinnie’s coming back again next month. That could be problematic.
But hey.. silver lining; You know how to save a severed limb and today, you added it to your list of accomplishments.